deamino-arginine-vasopressin and Brain-Ischemia

Vasculitis with central diabetes insipidus is a rare condition which must be recognized for an appropriate management. We report a case of Behçet disease with central diabetes insipidus. A forty seven year old men presented recurring oral and genital ulcers, skin lesions, polyarthralgia. Two years later, he showed right uveitis and central diabetes insipidus without dysfunction of the pituitary gland. Computed tomographic scan showed normal neurohypophysis and pituitary gland. Later on, he presented hemiplegia. The cerebral computed tomographic scan showed hypodense lesions. Central diabetes insipidus should not be systematically searched because it is a rare feature of the Behçet disease.

Topics: Behcet Syndrome; Brain Ischemia; Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Hemiplegia; Humans; Magnetic Resonance Imaging; Male; Middle Aged

Topics: Brain Ischemia; Cerebral Infarction; Deamino Arginine Vasopressin; Female; Humans; Infant; Intraoperative Complications; Kidney Failure, Chronic; Nephrectomy; Peritoneal Dialysis; Preoperative Care

We describe two families with heterozygous plasminogen deficiency. In the first the patient was a 27 year-old female who suffered an acute episode of ischemic cerebrovascular disease affecting the left temporal lobe documented by arteriographic, gammagraphic and CAT studies. She had no family history of thrombotic conditions. In the other family the propositus was a 31 year-old man with spontaneous deep venous thrombosis in the left leg. His father was also symptomatic, with a history of recurrent thrombotic complications after predisposing factors, that included multiple venous thrombosis and a pulmonary embolism. Laboratory data showed normal hemostasis test results. Antigenic and functional levels of protein C, protein S and antithrombin III were within normal limits. The only abnormality found was decreased plasminogen activity in plasma; antigenic and functional levels were reduced to about half-normal levels. In both cases crossed immunoelectrophoresis revealed a normal migration pattern of plasminogen. Thus, we conclude that our patients were carriers of congenital hypoplasminogenemia or familial type I plasminogen deficiency, due to decreased synthesis. We also reported on fibrinolytic response to infusion of DDAVP, a synthetic analogue of the antidiuretic hormone. Fibrinolytic activity was normal in basal conditions as well as in response to DDAVP infusion.

Topics: Adult; Blood Coagulation Tests; Brain Ischemia; Deamino Arginine Vasopressin; Disease Susceptibility; Female; Fibrinolysis; Humans; Male; Pedigree; Plasminogen; Pregnancy; Thrombophlebitis

We describe a patient who developed a delayed postoperative hematoma while receiving hypertensive therapy for delayed cerebral ischemia after aneurysm operation. The association between delayed extradural hematoma and induced hypertension has not been described previously.

Topics: Adult; Blood Pressure; Blood Transfusion; Brain Ischemia; Cerebrovascular Circulation; Combined Modality Therapy; Deamino Arginine Vasopressin; Dopamine; Female; Fluid Therapy; Hematoma, Epidural, Cranial; Humans; Intracranial Aneurysm; Subarachnoid Hemorrhage